Avaliação da aplicação do teste do reflexo vermelho em neonatos nascidos no Hospital da Mulher “Mãe Luzia” no Estado do Amapá

Abstract

In the global context, more than half the cases of blindness and low vision are due to congenital cataracts, retinopathy of prematurity, retinoblastoma and amblyopia. Early detection of visual changes may contribute to its prevention and treatment. Objective: To determine the characteristics of the population of neonates in Hospital da Mulher “Mãe Luzia”, who underwent the red reflex test. Method: This was a qualitative and quantitative, interventional and descriptive study, developed in the Hospital da Mulher “Mãe Luzia”, in the state of Amapá. The study complied with the ethical considerations in the Resolution 466/2012 from the National Health Council and obtained approval from the Ethics Committee of Federal University of Amapá (protocol number FR- 4584441 CEP). Eleven neonatologists were trained for the application of the red reflex test in the hospital. In order to obtain and record socioeconomic and biomedical data, we applied a questionnaire during a structured interview to person responsible for the neonate. We then proceeded to training for the divulgation of the red reflex test in the hospital and red reflex test examination. A neonatologist, a medical resident and a medical ophthalmologist voluntarily participated in the data collection for this study. Data collection occurred in two periods, the first from January to April 2012, with neonates at low risk for the development of ocular diseases, and the second from March to May 2013, with newborns susceptible to the development of ocular diseases. Data were processed with SPSS software 20.0. Qualitative maternal and newborn characteristics were described using absolute and relative frequencies and quantitative characteristics were described using mean and standard deviation. For data analysis, we used the chi-square Fisher's or likelihood ratio tests, Mann-Whitney test and odds ratio. The calculation of the correlation of maternal variables was done by Pearson and Spearman tests. The tests were performed with a significance level of 5%. Results: After obtaining the informed consent of the legal guardian, 629 interviews were conducted and the neonates were evaluated. There was no abnormality in the test results of 616 (98%) neonates. Neonates with abnormal or suspicious result in the red reflex test, 13 (2%) cases, were referred for follow-up in ophthalmologic consultations. Conclusion: This study provided specific information about the population studied as well as the correlation between maternal and neonatal biomedical variables and the abnormal/suspicious result in the red reflex test, which can contribute to support the concept of susceptibility of neonates to the development of ocular morbidity, it is imperative to adopt preventive measures in primary, secondary and tertiary care levels in the state of Amapá